Characteristics of atheromatosis in the prediabetes stage: a cross-sectional investigation of the ILERVAS project.
Aged
Asymptomatic Diseases
Atherosclerosis
/ diagnostic imaging
Biomarkers
/ blood
Carotid Artery Diseases
/ diagnostic imaging
Cross-Sectional Studies
Female
Femoral Artery
/ diagnostic imaging
Glycated Hemoglobin
/ metabolism
Humans
Male
Middle Aged
Plaque, Atherosclerotic
Prediabetic State
/ blood
Prevalence
Prognosis
Risk Assessment
Risk Factors
Severity of Illness Index
Sex Factors
Spain
/ epidemiology
Cardiovascular risk factors
Glycosylated hemoglobin
Prediabetes
Subclinical atheromatous disease
Journal
Cardiovascular diabetology
ISSN: 1475-2840
Titre abrégé: Cardiovasc Diabetol
Pays: England
ID NLM: 101147637
Informations de publication
Date de publication:
15 11 2019
15 11 2019
Historique:
received:
05
09
2019
accepted:
02
11
2019
entrez:
16
11
2019
pubmed:
16
11
2019
medline:
19
5
2020
Statut:
epublish
Résumé
Prediabetes has recently been associated with subclinical atheromatous disease in the middle-aged population. Our aim was to characterize atheromatous plaque burden by the number of affected territories and the total plaque area in the prediabetes stage. Atheromatous plaque burden (quantity of plaques and total plaque area) was assessed in 12 territories from the carotid and femoral regions using ultrasonography in 6688 non-diabetic middle-aged subjects without cardiovascular disease. Prediabetes was defined by glycosylated hemoglobin (HbA1c) between 5.7 and 6.4% according to the American Diabetes Association guidelines. Prediabetes was diagnosed in 33.9% (n = 2269) of the ILERVAS participants. Subjects with prediabetes presented a higher prevalence of subclinical atheromatous disease than participants with HbA1c < 5.7% (70.4 vs. 67.5%, p = 0.017). In the population with prediabetes this was observed at the level of the carotid territory (p < 0.001), but not in the femoral arteries. Participants in the prediabetes stage also presented a significantly higher number of affected territories (2 [1;3] vs. 1 [0;3], p = 0.002), with a positive correlation between HbA1c levels and the number of affected territories (r = 0.068, p < 0.001). However, atheromatosis was only significantly (p = 0.016) magnified by prediabetes in those subjects with 3 or more cardiovascular risk factors. The multivariable logistic regression model showed that the well-established cardiovascular risk factors together with HbA1c were independently associated with the presence of atheromatous disease in participants with prediabetes. When males and females were analyzed separately, we found that only men with prediabetes presented both carotid and femoral atherosclerosis, as well as an increase of total plaque area in comparison with non-prediabetic subjects. The prediabetes stage is accompanied by an increased subclinical atheromatous disease only in the presence of other cardiovascular risk factors. Prediabetes modulates the atherogenic effect of cardiovascular risk factors in terms of distribution and total plaque area in a sex-dependent manner. Trial registration NCT03228459 (clinicaltrials.gov).
Sections du résumé
BACKGROUND
Prediabetes has recently been associated with subclinical atheromatous disease in the middle-aged population. Our aim was to characterize atheromatous plaque burden by the number of affected territories and the total plaque area in the prediabetes stage.
METHODS
Atheromatous plaque burden (quantity of plaques and total plaque area) was assessed in 12 territories from the carotid and femoral regions using ultrasonography in 6688 non-diabetic middle-aged subjects without cardiovascular disease. Prediabetes was defined by glycosylated hemoglobin (HbA1c) between 5.7 and 6.4% according to the American Diabetes Association guidelines.
RESULTS
Prediabetes was diagnosed in 33.9% (n = 2269) of the ILERVAS participants. Subjects with prediabetes presented a higher prevalence of subclinical atheromatous disease than participants with HbA1c < 5.7% (70.4 vs. 67.5%, p = 0.017). In the population with prediabetes this was observed at the level of the carotid territory (p < 0.001), but not in the femoral arteries. Participants in the prediabetes stage also presented a significantly higher number of affected territories (2 [1;3] vs. 1 [0;3], p = 0.002), with a positive correlation between HbA1c levels and the number of affected territories (r = 0.068, p < 0.001). However, atheromatosis was only significantly (p = 0.016) magnified by prediabetes in those subjects with 3 or more cardiovascular risk factors. The multivariable logistic regression model showed that the well-established cardiovascular risk factors together with HbA1c were independently associated with the presence of atheromatous disease in participants with prediabetes. When males and females were analyzed separately, we found that only men with prediabetes presented both carotid and femoral atherosclerosis, as well as an increase of total plaque area in comparison with non-prediabetic subjects.
CONCLUSIONS
The prediabetes stage is accompanied by an increased subclinical atheromatous disease only in the presence of other cardiovascular risk factors. Prediabetes modulates the atherogenic effect of cardiovascular risk factors in terms of distribution and total plaque area in a sex-dependent manner. Trial registration NCT03228459 (clinicaltrials.gov).
Identifiants
pubmed: 31729979
doi: 10.1186/s12933-019-0962-6
pii: 10.1186/s12933-019-0962-6
pmc: PMC6857207
doi:
Substances chimiques
Biomarkers
0
Glycated Hemoglobin A
0
hemoglobin A1c protein, human
0
Banques de données
ClinicalTrials.gov
['NCT03228459']
Types de publication
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
154Investigateurs
Ferran Barbé
(F)
José-Manuel Valdivielso
(JM)
Glòria Arqué
(G)
Jessica González
(J)
Ana Vena
(A)
Eva Miquel
(E)
Marta Ortega-Bravo
(M)
Gerard Torres
(G)
Serafín Cambray
(S)
Manuel Portero-Otin
(M)
Mariona Jové
(M)
Montserrat Martínez-Alonso
(M)
Eva Castro
(E)
Pere Godoy
(P)
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